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Permit r A k �P A „�f PITY O F TIGARD ELECTRICAL PERMIT • PERMIT #: ELC2004 -00567 : . DEVELOPMENT SERVICES DATE ISSUED: 9/7/2004 • l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 25111 DD -15500 SITE ADDRESS: 08705 SW HAMLET ST SUBDIVISION: MILLMONT PARK ZONING. R -7 BLOCK: LOT : 032 JURISDICTION: TIG Project Description: Gas furnace circuit, A/C circuit, weather proof outlet. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: WROLSTAD, KIMBERLY A THE ELECTRIC GROUP 8705 SW HAMLET ST 4726 SE MILWAUKIE AVE. TIGARD, OR 97224 PORTLAND, OR 97202 Phone: 503 - 639 -9472 Phone: 503 - 232 -2499 Reg #: ELE 24 -445C LIC 43851 FEES SUP 2085S Description Date Amount Required Inspections [ELPRMT] ELC Permit 9/7/2004 $60.15 [TAX] 8% State Surcharge 9/7/2004 $4.82 Rough - Elect'I Final Total $64.97 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, •r if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted b the Oregon 'lity Notific- ion Center. Those rules a re set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of • -s- • es o sir- it ques to OUNC at (503) 246 -6699 or 1 -000- 332 -2344. / /' --� . Issued By: .72 2 ,Ci,�,_,r� � 7 ,e;p Permit Signature: .A S,..,,/Ml/ � OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: • CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639 -4175 by 7:00pm for an inspection the next business day Electr .ta-1 P_ ermitpApp`1iGat1011 FOR OFFICE USE ONLY v„ 1 w. au v City of Tigard e DateB Received G� 7 L _ PermitNo.: �L, a(�'y - 1 13125 SW Hall Blvd., Tigard, OR r � 9 l 00 � 7 2 Plan Review Phone: 503.639.4171 Fax: 56'1 14 :444 ' . Date/B : Other Permit: Inspection Line: 503.639.4175 p c a. CI I Date Ready/By: El See Page 2 for Internet: www.ci.tigard.or.us �i- nF TSGAR® Notified Method Supplemental Information ' , � ` » i; :5' 'n� E �.. : h•. ks,•Y .a.f, +�ya'��X� 'c.v,}: ✓. sR.... �X.Y 5 I wwbF W®RK >i "3.- 2 a ea a tia i.01 ��?V-''' ' �- �.;��� � S m-� �..'. � � .� �^A.. ` ..�.'av: -te " .� ^ ['New construction Addition /alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: ['Service over 225 amps, comm'l Hazardous cation ['Service . . ,_,�., F „ E z � » Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., 'ir , , ' " 1> g TM- ®N S ,T R Z ,,C ib' r of 1 - and 2- family dwellings 4 or more new residential / 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure El Multi - family El Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more ,,�,e l „ y j y ,. << r< g , i ,, 1 ,�, r , ['Occupant load over 99 persons EManufactured structures or l i t ,' it. . JO41.§ 4:141 FORMATLOiv e Y LOCAT '-" " = ` ess / li htin a 'tea ,���..,� �a�_m<:'.�e .��::*_.��.�,�e",exza:.�:_... ��i. x - r . �.�.�.,�,: 31:-"'::.' "�*�� - �v ❑ E gr g g P 1 a RV. park Job no.:�3�� Job site address: �'y0 5 so p . 5+ ❑Health - care facility ['Other: Submit 2 sets of plans with any of the above. City /State /ZIP: 1 - 1 6 R D Q ie , L T 6 . 0 4) Cj 7. Z z The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: Re /.../. W , (54-44 " *' R «TF = tSC I> DU< E ,• I Description Qty. Fee. Total Cross street/directions to job site: SW I-10 LC BC.V1) 40 - £.0 ['aka - New residential single - or multi - family dwelling unit. Includes attached garage. - 7 - 4err'25 •lJO/e - 5 T 5 5:9- 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Tax Y . t s µ „ g R Limited energy, non - residential 75.00 2 h i � 'D`S E RITIO P,1�,0 ' WOP'.Y ,, ''h ` ' ~ "c ,�r�'t „� ... �;� ; ,� , _�a _Y. �.� �,�; ��� - :��;�a'�.� �»�,,, �. Each manufactured or modular 6 .--5/ , dwelling, service and /or feeder 90.90 2 f' ' L.GL� c i r'�f / f 1 4I. -CDyCl r 1/6 -ti e; Pull T Services or feeders installation, alteration, and /or relocation /1/6-;d7!!G Z ,/'©U 04e 7W% • 200 amps or less 80.30 2 w "NS. :y4 .: r ,- <.. ,,g ., << ...o :,;,�c . 201 am s to 400 amps 106.85 2 PROPERT ` ❑ i . V.. p �. , � Y*O ER r'' _� TEN T s'"� �., ��. < ,�,o- M ,. _� r..w» <� ��� -;. 401 amps to 600 amps 160.60 2 Name: Ka, vii W fz0ktelci 601 amps to 1,000 amps 240.60 2 l Address: ( 9 1 70 S (,V ( 4 ,1 .--te.� Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: &AA i ) er:7(2,6 ' g Z2_y Temporary services or feeders installation, alteration, and /or Phone: (5v3) a 3 9_94/7 a Fax: ( ) 2 200 a amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchan e, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: /� Branch circuits - new, alteration, or extension, per panel 1 ` Y. "` ;; AP NIe V T PI: ' ;. IF' 'l t A. Fee for branch circuits with „; :. 1t -,,:i...,,,.....,,,-4- = J , 4 , t4 , ;' 1 ,. 5 s O NT A C , T PERS t '�`�" " °i� t service or feeder fee, each Business name: Tilt-- 6 Q p /Alc /Al branch circuit 6.65 2 r B. Fee for branch circuits Contact name: - via / - 4- Aif-Est/ without service or feeder fee, each branch circuit I 46.85 L/� S� 2 Address: ...792 6 __s-&- Jj7 /[ ,w&-- Each add'l branch circuit 2 6.65 13 2 City /State /ZIP: 7Q2TG4.�� 02w -a.,51.ti 9 229 2_ Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: (SD (7,99 Fax: : (973 )z 30)6? Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - t `* f"w"' k is ` CONTRACTOTi 5�' "' .; ener panel, alteration, or •es'� .N� _. .. .. �.f. ". .:a°s ' -'�. _a.."` ; extension. Describe: Page 2 2 Business name: T7 - e 72i e �200- /4)e.- Address: � 7 z 6o Ste- /G (VQ jg ..i 4 (fG , Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: �0/QT 4 AID / ORE6t2A) 92c' Z. Investigation per hour (1 hr mim) 62.50 Phone: (v ) 23 2 . . - 4 1 9 1 ' Fax: (503) 2z-31 G er Industrial plant per hour 73.75 NEEMIARKWMAMWAFRIMZEM CCB Lic.:e Electrical Lic.A64/r$ Suprv. Lic.:O35 - 5 Subtotal 60 15 Suprv. Electrician signature, required: Ok e Plan review (25% of permit fee) Print name: TM S k4k79 U Date: g - 7- ar�0 °/ State sur (8% of permit fee) I", g 2 TOTAL PERMIT FEE 6;4, 4 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i PemutApp doe 12/03 440- 4615T(10/02/COM /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: e�M. »eux..s ,«;,:,.� ...e e':;,W �ULl TWW, RTC { N1. i' ' ` . Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: `CO. i2111 Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical H Nurse Calls ❑ Outdoor Landscape Lighting* H Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i: \ Building \Pernuts\ELC- PemiltApp.doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested � oZ AM PM BUP Location 7&T Suite MEC \ � o / ' s Contact Person Ph ( ) PLM Contractor Ph ( SWR BUILDING Tenant/ ri r . i /L_ —'! �� ELC .6 O - 56 Footing —9 ELC Foundation Access: Ftg Drain �3 ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation pLYY\ e> yo)is Drywall Nailing 1 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL G Po ) Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Nb Shower Pq � � • per: H Ii iFFI� PART FAIL CHANT P eam Rough-In Gas a Line Smoke Dampers r- in 14-7 PART FAIL CTRC Service Rough -In f ; F UG/Slab l� Low Voltage Fire Alarm F Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date ?/ Inspector L � ✓`�� Ext Other: Final DO NOT REMOVE this inspection record from t site. PASS PART FAIL